CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: The Children's Mercy Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $64
Cash Discount Price: $48
vs. Medicare Baseline: 7.57x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at The Children's Mercy Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 7.57x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $48 (567%)

Insurance Median: $64 (757%)

Cash: $48 (567% of Medicare)

Ins. Median: $64 (757% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 757% of the Medicare baseline (a markup of 657%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Healthy Blue	$9 - $23	106%
UnitedHealthcare	$9 - $67	106%
Medicaid / KanCare	$10	118%
Home State Health	$20	236%
Blue Cross Blue Shield	$41 - $73	485%
Cigna	$48 - $69	567%
Medica	$58	686%
Aetna	$59 - $67	697%
Centivo	$64	757%
Health Midwest Comprehensive Care	$64	757%
Nebraska Furniture Mart	$64	757%
Orscheln	$64	757%
Quiktrip	$64	757%
Wellfit/Centrus	$64	757%
Wppa Providrs Care	$64	757%
Humana	$66	780%
Coventry Health Care Of Kansas	$73	863%
Coxhealth Network	$73	863%
Mercy Health	$74	875%
Multiplan	$75	887%
American Healthcare Alliance	$84	993%
Healthlink	$87	1028%
National Preferred Provider Network	$89	1052%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $48.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.